Location: West Harrison,NY, USA
RN Care ManagerCare ManagementFull TimeDayMon-Fri, 8:30a-4:30p or 9a-5p; monthly weekend rotation(Saturday & SundaySign On Bonus : $5,000Salary Range: $119,970.24 - $153,900.24Position Summary The RN Care Manager performs the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high risk indicators (i.e. AIMS, Geisinger, polypharmacy) to ensure high risk patient populations receive the appropriate supportive services for discharge to prevent readmission and assess all populations for potential discharge planning needs. Provides ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy.Essential Functions and Responsibilities Includes the Following: Understands and adheres to the WPH Performance Standards, Policies and BehaviorsCompletes a comprehensive initial assessment.Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.Performs all transitional planning activities including but not limited to: Patient/caregiver educationArrangement of all aftercareCommercial payer involvementHigh utilizer patient root causeCommunicates and collaborates all relevant patient information to appropriate health team members.Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.Documents per department requirements.Participates in Performance Improvement activities as needed.Performs all UR activities per department policy: Commercial payer reviewsDisposition determination,Retro/self-auditMC varianceAdmission clinical review.Performs all other related duties as assignedEducation & Experience Requirements BSN or related Bachelor's degree required5 years clinical ED, critical care or med/surg experience requiredPrevious case management experience preferredKnowledge of healthcare financial, regulatory, and payer issues preferredKnowledge of state, local, and federal programs strongly preferredExperience in use of Milliman/InterQual criteriaRegistered Nurse (RN) NYS license requiredPRI/Screen certification strongly preferred.C.C.M. (Certified Case Manager) certification preferredComputer skills essential